scholarly journals The Edinburgh Feeding Evaluation in Dementia Scale: A Longitudinal Study in Nursing Home Residents

2017 ◽  
Vol 44 (3-4) ◽  
pp. 196-202 ◽  
Author(s):  
Roger Watson ◽  
Annamaria Bagnasco ◽  
Gianluca Catania ◽  
Giuseppe Aleo ◽  
Milko Zanini ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Time Points ◽  
Test Information ◽  
Fit Statistics ◽  
Item Fit ◽  
Mokken Scaling ◽  
Scaling Methods ◽  
The Mean ◽  
Test Information Function

Aims/Background: The Edinburgh Feeding Evaluation in Dementia (EdFED) scale has been shown to have good psychometric properties using a range of methods including Mokken scaling. We aimed to study the Italian version of the EdFED using Mokken scaling. Methods: Data were gathered at 7 time points from 401 nursing home residents affected by dementia in the course of a 6-month intervention study using analysis of variance, Mokken scaling, and person-item fit statistics. Results: The properties of the EdFED-I scale were stable over the course of the study with 4 items showing invariant item ordering at all time points. Some items behaved differently at different levels of difficulty in the scale and also depending on the mean level of feeding difficulty. The test information function showed a dip in the mid-range of difficulty scores.

scholarly journals Predictors of drug prescription in nursing home residents: results from the INCUR study

2021 ◽  
Author(s):  
Laura Calcaterra ◽  
Marco Proietti ◽  
Edoardo Saporiti ◽  
Vanessa Nunziata ◽  
Yves Rolland ◽  
...  
Keyword(s):  
Nursing Home ◽  
Older Persons ◽  
Drug Prescription ◽  
Frailty Index ◽  
Nursing Home Residents ◽  
Public Health Issue ◽  
Linear Regression Models ◽  
The Mean ◽  
Independent Association ◽  
Post Hoc

AbstractPolypharmacy represents a major clinical and public health issue in older persons. We aimed to measure the prevalence of polypharmacy, and the main predictors of drug prescription in nursing home residents. Post hoc analyses of the “Incidence of pNeumonia and related ConseqUences in nursing home Residents” (INCUR) study were conducted. Polypharmacy was defined as the prescription of 5 or more drugs. A frailty index (FI) was computed according to the model proposed by Rockwood and Mitnitski using 36 health deficits, including diseases, signs, symptoms, and disabilities. Linear regression models were performed to identify the main predictors of the number of prescribed drugs. The INCUR study enrolled 800 patients (mean [SD] age 86.2 [4.1] years, 74.1% women). The mean number of medications prescribed at the baseline was 8.5 (SD 4.1). Prevalence of polypharmacy was found 86.4%. The mean FI was 0.38 (SD 0.10). A fully adjusted linear multivariate regression model found an inverse and independent association between age and number of prescribed drugs (beta − 0.07, 95% CI − 0.13, − 0.02; p = 0.005). Conversely, the FI was independently and positively associated with the number of medications (beta 4.73, 95% CI 1.17, 8.29; p = 0.009). The prevalence of polypharmacy is high among older persons living in nursing home. Age and FI are significantly associated with the number of drugs. The number of prescribed drugs tends to decrease with age, whereas a direct association with frailty is reported.

scholarly journals Are Dementia Patient's Engagement Using Tailored Stimuli the Same? The Apathy Dilemma in Nursing Home Residents

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Elsa Leone ◽  
Audrey Deudon ◽  
Julie Piano ◽  
Philippe Robert ◽  
Arnaud Dechamps
Keyword(s):  
Clinical Trial ◽  
Nursing Home ◽  
Mmse Score ◽  
Nursing Home Residents ◽  
Stimulus Category ◽  
Behavioural Disturbance ◽  
Superiority Effect ◽  
Icd 10 ◽  
The Mean ◽  
Significant Superiority

Background. Apathy is the most frequent behavioural disturbance understanding how apathy drives engagement in resident’s activities of interests is a milestone to better understanding and tailored challenging interventions targeting engagement enhancement.Method. Residents aged 60 and older with dementia according to the ICD 10 from four nursing homes in the south east of France. A set of 25 stimuli were used and categorized by participant into Work, Leisure, Family, or Personal categories, an additional “not interested” category was used for comparison of engagement. The participants stimuli allocation was randomized in guided and unguided situations over a two-week period with 15minute interaction for each stimulus (n=2) of each category (5×(15 min×2)). Clinical trial identifier: NCT01314131.Results. The mean age, 95% confidence interval (CI) of the 40 participants was 85.4 (83.8–87) with a mean MMSE score, CI95% of 17.7 (16.5–19). Analyses revealed a significant superiority effect of guidance over unguided interaction in duration of engagement in all categories of interest except for the stimulus category “family” and allP<.05. Apathetic participants when guided had longer engagement duration in stimulus Leisure and Personal (allP<.01).Conclusion. Guidance and better activities of interest can lead to enhanced engagement time in participants with dementia.

scholarly journals CMV seropositivity does not increase the risk of death among elderly nursing home residents

2020 ◽  
Vol 19 (4) ◽  
pp. 216-220
Author(s):  
Dorota Pytka ◽  
Bożena Czarkowska-Pączek ◽  
Aleksandra Wyczałkowska-Tomasik
Keyword(s):  
Nursing Home ◽  
Antibody Titre ◽  
Genetic Material ◽  
Nursing Home Residents ◽  
Cmv Infection ◽  
Exact Test ◽  
Risk Of Death ◽  
Chi Squared ◽  
The Mean ◽  
The Impact

AbstractAim. The aim of this study was to assess the anti-CMV antibody titre, the presence of genetic material of the virus in the plasma of elderly residents of nursing homes and the impact of the CMV infection on the risk of death.Material and methods. The number of 202 residents of a nursing home in Warsaw, aged 65 and over, were observed for 1095 days (3 years) between 2015 and 2018. During this period 126 (62.4%) residents died. Plasma CMV DNA levels were assessed using real-time PCR. Anti-CMV antibody titre was measured with the use of commercially available ARCHITECT CMV test.Results. No genetic material of the CMV was found in the studied group of the residents. The mean IgG titre did not differ between those who survived and those who deceased (p=1). Pearson’s Chi-squared test and Fisher’s exact test did not reveal any differences in the rate of deaths among the groups of seronegative, seropositive < 250 IgG [Au/ml], and seropositive > 250 IgG [Au/ml] residents. Kaplan-Meyers survival curves confirmed these results.Conclusions. We did not demonstrate that CMV infection or the anti-CMV antibody titer have any effect on the risk of death in the study group.

PREVALENCE OF PREFRAILTY AND FRAILTY IN SOUTH AMERICA: A SYSTEMATIC REVIEW OF OBSERVATIONAL STUDIES

2020 ◽  
pp. 1-17
Author(s):  
H.J. Coelho-Junior ◽  
E. Marzetti ◽  
A. Picca ◽  
R. Calvani ◽  
M. Cesari ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
South America ◽  
Nursing Home Residents ◽  
South American ◽  
Frailty Assessment ◽  
The Mean ◽  
Hospitalized Older Adults ◽  
Negative Health Outcomes ◽  
Specific Country

Objectives: The present study aimed at investigating the prevalence of prefrailty and frailty in South American older adults according to the setting and region. Design: A literature search combining the terms “frailty”, “South America” or a specific country name was performed on PubMed, EMBASE, Lilacs, and Scielo to retrieve articles published in English, Portuguese or Spanish on or before August 2019. Participants: Older adults aged 60+ years from any setting classified as frail according to a validated scale were included in the study. Measurements: Frailty assessment by a validated scale. Results: One-hundred eighteen reports (98 performed from Brazil, seven from Chile, five from Peru, four from Colombia, two from Ecuador, one from Argentina, and one from Venezuela) were included in the study. The mean prevalence of prefrailty in South America was 46.8% (50.7% in older in-patients, 47.6% in the community, and 29.8% in nursing-home residents). The mean prevalence of frailty in South America was 21.7% (55.8% in nursing-home residents, 39.1% in hospitalized older adults, and 23.0% in the community). Conclusions: Prefrailty and frailty are highly prevalent in South American older adults, with rates higher than those reported in Europe and Asia. In the community, almost one-in-two is prefrail and one-in-five is frail, while hospitalized persons and nursing-home residents are more frequently affected. These findings indicate the need for immediate attention to avoid frailty progression toward negative health outcomes. Our findings also highlight the need for specific guidelines for the management of frailty in South America.

Variability of total phenytoin serum concentrations within elderly nursing home residents

Neurology ◽  
2003 ◽  
Vol 60 (4) ◽  
pp. 555-559 ◽  
Author(s):  
A. Birnbaum ◽  
N. A. Hardie ◽  
I. E. Leppik ◽  
J. M. Conway ◽  
S. E. Bowers ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Resident ◽  
Nursing Home Residents ◽  
The Elderly ◽  
The United States ◽  
Serum Concentrations ◽  
Minimum Concentration ◽  
Elderly Nursing Home Resident ◽  
The Mean

Background: Approximately 6% of all elderly nursing home residents receive phenytoin. Phenytoin concentrations are often measured to guide therapy.Objective: To evaluate the intraresident variability among multiple measurements of total phenytoin serum concentrations in nursing home residents.Methods: This was an observational study of 56 elderly (≥65 years) nursing home residents from 32 nursing homes who had at least 3 phenytoin concentrations measured while on the same dose of phenytoin for at least 4 weeks and who were not taking any interfering concomitant medications. These were a subset of 387 elderly nursing home residents from 112 nursing homes across the United States who had total phenytoin concentration measurements between June 1998 and December 2000.Results: The mean age was 80.1 years (range, 65 to 100 years) and 58.9% were women. The mean daily dose of phenytoin per resident was 4.9 ± 1.5 mg/kg. Total phenytoin concentrations within an elderly nursing home resident varied as much as two- to threefold, even though there was no change in dose. The person with the smallest variability had a minimum concentration of 10.0 μg/mL and a maximum of 10.4 μg/mL. The person with the largest variability had a minimum concentration of 9.7 μg/mL and a maximum of 28.8 μg/mL.Conclusions: There is considerable variability in the total phenytoin concentrations in the elderly nursing home resident and measurement of a single total phenytoin concentration should not be used to guide treatment.

scholarly journals PHYSICAL ACTIVITY AND FUNCTIONAL FITNESS IN ELDERLY LIVING IN NURSING HOMES OR USING DAY CARE CENTERS: AN EXPLORATORY STUDY

2018 ◽  
pp. 81-96
Author(s):  
Soraia Ferreira ◽  
Nilton Leite ◽  
José Marmeleira ◽  
Armando Raimundo
Keyword(s):  
Physical Activity ◽  
Nursing Home ◽  
Sedentary Behavior ◽  
Day Care ◽  
Care Center ◽  
Nursing Home Residents ◽  
Functional Fitness ◽  
Day Care Center ◽  
The Mean ◽  
Mean Time

Introduction. The loss of physical functions, health problems, limited support from families and few financial resources, leads to institutionalization (Sullivan & Asselin, 2013). Currently, one of the problems associated with institutionalization is the higher sedentary behavior and consequent loss of autonomy (Liu & Hu, 2015). Therefore, the main purpose of this study was to examine physical activity levels and functional fitness of older adults living in nursing homes or using day care center. Method. Thirty-two older adults (85.5 ± 5.7 years) from both genders participated in this study; 14 nursing home residents and 18 day care center users. Physical activity data were collected through accelerometry. Functional fitness were evaluated with physical fitness field tests. Results: The participants of this study have extremely low levels of functional fitness and physical activity and high levels of sedentary behavior. In nursing home residents (NH), the mean time in sedentary behavior and moderate physical activity was 9h48min/day and 2.2 min/day, respectively. In the same group, the mean time spent in light physical activity was 77.5 min/day. In day care center (DCC) users the mean time in sedentary behavior and moderate physical activity was 7h48min/day and 1.6 min/day, respectively. Older adults attending DCC showed better results than nursing home residents in the chair sit-and-reach test (DCC= -12.4±15.7 cm, NH= -22.3±4.1 cm, p=0.037), 6 min walk (DCC= 270±73.9 min, NH= 167.7±84.4 min, p<0.001) sedentary time (DCC= 7.48±0.2 hours, NH= 9.48±0.94 hours, p<0.01) and average physical activity (DCC= 82.6±18 counts/min, NH= 58.5±30.5 counts/min, p=0.03). The performance in other variables of functional fitness was not statistically different. Conclusions: Functional fitness and physical activity levels are very low in nursing home residents and in elderly users of day care center. Intervention programs are needed for these groups to reverse the decrease of physical fitness and physical activity, and promoting health and functional status.

Satisfaction of Discharged Nursing Home Residents

2016 ◽  
Vol 37 (10) ◽  
pp. 1225-1243 ◽  
Author(s):  
Nicholas Castle ◽  
John Engberg ◽  
Aiju Men
Keyword(s):  
Nursing Home ◽  
Psychometric Properties ◽  
Healthcare Providers ◽  
Nursing Home Residents ◽  
Participation Rate ◽  
The United States ◽  
Confirmatory Factor Analyses ◽  
Fit Statistics ◽  
Industry Standard ◽  
Consumer Assessment

The psychometric properties of The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Nursing Home survey: Discharged Resident Instrument (NHCAHPS-D) are examined. A random sample of 550 nursing homes was selected from across the United States and 365 agreed to participate (participation rate = 66%). From 7,020 surveys sent to discharged residents, 4,926 were returned (response rate = 70%). The psychometric properties of the resident responses and the survey items were robust. Confirmatory factor analyses model fit statistics met the criterion for good conformance. Five of the initial NHCAHPS-D instrument domains were identified (environment, care, communication and respect, autonomy, and activities), along with a sixth (transitions) added by the authors. The standardization and reliability that NHCAHPS-D provides could facilitate the same benefits we have seen in other industries for the CAHPS family of instruments (i.e., quality improvement, reimbursement, public reporting, and benchmarking) and also become an industry standard.

scholarly journals PIMAVANSERIN IN ALZHEIMER’S DISEASE PSYCHOSIS: EFFICACY IN PATIENTS WITH MORE PRONOUNCED PSYCHOTIC SYMPTOMS

2018 ◽  
pp. 1-7
Author(s):  
C. Ballard ◽  
J.M. Youakim ◽  
B. Coate ◽  
S. Stankovic
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
The United States ◽  
Psychotic Symptoms ◽  
Tolerability Profile ◽  
Double Blind ◽  
The Mean

Background: Pimavanserin is a 5-HT2A receptor inverse agonist/antagonist and is approved in the United States for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. Objective: Evaluate the efficacy of pimavanserin on symptoms of psychosis in patients with Alzheimer’s disease (AD). Design: Randomized, double-blind, placebo-controlled trial Setting: Nursing home residents Participants: Patients with AD psychosis Interventions: Pimavanserin 34 mg or placebo daily for 12 weeks Measurements: The primary endpoint was mean change from baseline at Week 6 on the Neuropsychiatric Inventory-Nursing Home Version psychosis score (NPI-NH-PS). In the prespecified subgroup analysis, the mean change in NPI-NH-PS and the responder rates among those with baseline NPI-NH-PS ≥12 were evaluated. Results: Of 181 patients randomized (n=90 pimavanserin; n=91 placebo), 57 had baseline NPI-NH-PS ≥12 (n=27 pimavanserin; n=30 placebo). In this severe subgroup, large treatment effects were observed (delta=-4.43, Cohen’s d=-0.73, p=0.011), and ≥30% improvement was 88.9% vs. 43.3% (p<0.001) and ≥50% improvement was 77.8% vs. 43.3% (p=0.008) for pimavanserin and placebo, respectively. The rate of adverse events (AEs) in the severe subgroup was similar between treatment groups, and urinary tract infection, fall, and agitation were most frequent. Serious AEs was similar with pimavanserin (17.9%) and placebo (16.7%) with fewer discontinuations due to AEs with pimavanserin (7.1%) compared to placebo (10.0%). Minimal change from baseline occurred for the mean MMSE score over 12 weeks. Conclusions: Pimavanserin demonstrated significant efficacy in AD psychosis in patients with higher baseline severity of psychotic symptoms (NPI-NH-PS ≥12). Treatment with pimavanserin showed an acceptable tolerability profile.

scholarly journals Trends in quality of care and dying perceived by family caregivers of nursing home residents with dementia 2005–2019

2021 ◽  
pp. 026921632110308
Author(s):  
Maartje S Klapwijk ◽  
Sascha R Bolt ◽  
Jannie A (Nienke) Boogaard ◽  
Maud ten Koppel ◽  
Marie-José HE Gijsberts ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Family Caregivers ◽  
Nursing Home Residents ◽  
Well Being ◽  
Quality Of Dying ◽  
The Mean ◽  
Bereaved Family ◽  
Over Time

Background: Dementia palliative care is increasingly subject of research and practice improvement initiatives. Aim: To assess any changes over time in the evaluation of quality of care and quality of dying with dementia by family caregivers. Design: Combined analysis of eight studies with bereaved family caregivers’ evaluations 2005–2019. Setting/participants: Family caregivers of nursing home residents with dementia in the Netherlands ( n = 1189) completed the End-of-Life in Dementia Satisfaction With Care (EOLD-SWC; quality of care) and Comfort Assessment in Dying (EOLD-CAD, four subscales; quality of dying) instruments. Changes in scores over time were analysed using mixed models with random effects for season and facility and adjustment for demographics, prospective design and urbanised region. Results: The mean total EOLD-SWC score was 33.40 (SD 5.08) and increased by 0.148 points per year (95% CI, 0.052–0.244; adjusted 0.170 points 95% CI, 0.055–0.258). The mean total EOLD-CAD score was 30.80 (SD 5.76) and, unadjusted, there was a trend of decreasing quality of dying over time of −0.175 points (95% CI, −0.291 to −0.058) per year increment. With adjustment, the trend was not significant (−0.070 EOLD-CAD total score points, 95% CI, −0.205 to 0.065) and only the EOLD-CAD subscale ‘Well being’ decreased. Conclusion: We identified divergent trends over 14 years of increased quality of care, while quality of dying did not increase and well-being in dying decreased. Further research is needed on what well-being in dying means to family. Quality improvement requires continued efforts to treat symptoms in dying with dementia.

Erratum: Hearing Levels among Elderly Nursing Home Residents

1980 ◽  
Vol 45 (2) ◽  
Author(s):  
Ronald L. Schow ◽  
Michael A. Nerbonne
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Male And Female

In the February 1980 issue of this journal, the report by Ronald L. Schow and Michael A. Nerbonne ("Hearing Levels Among Elderly Nursing Home Residents") contains an error. On page 128, the labels "Male" and "Female" in Table 2 should be reversed.

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